New Year…New Life and a Better World

The end of one year and the beginning of the next is a time of goodbyes and hellos. It is a time of good wishes and of wishing for the prosperity of loved ones and for all of humanity. But, above all, it is a time for balance, good purposes and intentions. ...

When the year ends, we evaluate what has been achieved and what has not been achieved with respect to the objectives and goals that we set for the ending year ... goals that range from the merely individual and very personal to those that transcend family, social, racial, ideological and cultural boundaries, to open ourselves up to the best intentions and purposes for the good of all of us who inhabit the earth.

We all live, even he who ignores it and he who doubts it, through times of profound changes and crises that affect us all, anguish us and fill us with uncertainty regarding the immediate future in each of our lives, in the lives of those closest to us, of our compatriots, and of the world. ...

Changes and crises that touch all strata of human life in society and throughout the planet. Crises and changes that involve all spheres of society: political, economic, religious, cultural, social, etc. ... crisis in social frameworks, crisis in institutions and in social organizations. There are crises and changes in the traditionally known and established. ... If anything characterizes our time, it is the uncertainty about what is to come ...

Nobody, no one among us, is or can be a passive or foreign spectator before what is happening in this stage of man’s life on earth. We all share responsibility for the history that we are building or destroying. We are profoundly united in good and in evil. None of our words and deeds, our actions or omissions ceases to have an impact on the daily human task of building better personal lives, better families, a better society and a better world. ...

A brief analysis of our current reality at a micro or macro level, on a personal, family, social, national or global level, allows us to recognize great advances and, at the same time, enormous and very serious problems.

The advances involve, mostly, the growth in the material and financial, the world of markets, of science, of the technical, of technology and of telecommunications. But, unfortunately, it seems that as we grow materially, we regress morally and spiritually. Evidence from the news and daily events alerts us to the decrease in the world of the deeply human values and ideals that sustain and promote the construction of a better world, one that is more just, more equitable, more supportive, more compassionate, more fraternal: a world like a great table in which everyone has the right to a seat and to share in peace and prosperity.

I wish, at the beginning of this new year 2019, that we all become aware of the importance of each of our very personal and individual intentions, decisions, actions or omissions for the construction of social frameworks and institutions. That we understand, once and for all, that our daily life and being is not insignificant to the destiny of all humanity. That our contribution and our grain of sand counts, a great deal, in the mountain ranges of good and well-being that we must build as we search for a better present and better tomorrow for all. That, daily, we are not spectators, but protagonists of our own story and the stories of our neighbors.

Because if our biggest and most serious problems and crises involve social frameworks being eaten away by corruption, this is due to the crisis of the men who create them, shape and sustain them and, more than that, to the deep crisis of values inside each of us: a crisis in the spirit of man, of men; a crisis in the human spirit.

Therefore, I invite everyone to evaluate, honestly, the principles, values, goals and ideals that govern our attitudes and actions. I invite everyone at this time, as one year ends and another comes, for which we are so hopeful, to fill ourselves with the best wishes, to make the best resolutions, and to work to make 2019 a year of better successes in the pursuit of the common good and for peace for all men and all peoples of the world.

There is much we have done, but much more that we still have to do. Our story and our destiny are in the hands of each one of us. And our work and daily actions depends upon who we are, morally and genuinely, as individuals, and on our values and interests. And because our deeds reflect our values, I wish that every day of 2019 will reveal each one of us as better human beings and better citizens of the world. The song says it well: "New Year, New Life, happier days are coming... HAPPY AND PROSPEROUS NEW YEAR!”

CHRISTMAS: A CALL TO ACTION ...

There are men and women whose lives we cannot ignore: Simón Bolívar, Joan of Arc, Martin Luther King, Marie Curie, Gandhi, Teresa of Calcutta, Marx, Rosa Parks, Edith Stein.... What did these men and women do to make the impact they had on the history of humanity? What they did was to simply live, and make of their lives, a call to action.... Among them is a man who produced the greatest impact in the history of humanity: JESUS ​​OF NAZARETH. We count 2018 years of history since his birth in the small village of Bethlehem. This event is what marks the holiday season in the world. If there are messages, lights, gifts, trips, vacations, premieres, family reunions, music and parties, it is because we celebrate another anniversary of his birth.

December, then, reminds the world of the birth of Jesus of Nazareth, but with the celebration of his birth we remember, above all, his great contributions to the history of humanity and what his whole life, his deeds and his words symbolize and mean not only for his disciples, Christians for all ages, but for every man and woman of good will.

Thus, above all, the entire life and work of Jesus of Nazareth contains a proposal, an invitation for all human beings to build a better world through recognizing that we are brothers, children of the same God, who as we were taught by Him, we call a good, compassionate and merciful Father. A recognition through which we can achieve the happiness we all long for by loving one another, serving, forgiving, sharing, expressing solidarity, tolerating each other, understanding each other. This proposal of LOVE clashes with all forms of selfishness, injustice, discrimination, violence and death.

The proposal of Jesus of Nazareth, with his message and the testimony of his life, are, permanently, a call, an invitation and a challenge to the whole world to make our existence on earth a better and kinder space and time for every man and woman who comes to this world.

The celebration of Christmas, the birth of Jesus of Nazareth, on the other hand, reminds us of and marks us all a course, a path, a life philosophy, a logic, principles, values, a meaning for life that normally is neither our path nor our logic. Thus, while we build a life and a society in which what matters is to have, to pretend, to enjoy at whatever cost, to take care of and protect ourselves selfishly, to hoard, to accumulate, to run over and to crush to climb, to get ahead, to rise above others.... Jesus of Nazareth will always remind us of another logic, another direction for the life of men on earth if we want to be happy: the logic of the nativity scene of Bethlehem, of humility, of humbling, of detachment, of the total giving of one’s life, the logic of service to  others, especially the neediest, to the very end, the logic of forgiveness, the logic of love, even to the cross....

Finally, the celebration of CHRISTMAS also reminds us all - not only Christians - of the importance of the human, of the truly human. The deep and Christian meaning of Christmas contains and reveals to all this truth: God cares about humanity and everything that is deeply human. He cares for the child wrapped in swaddling clothes and lying in the manger, for the man who preached in Galilee and washed the feet of his disciples, for he who healed lovingly and was given to all without measure, for he who came into conflict with the legal and cultural institutions of his time because he placed love above all else, to the point that he died hanging on a tree. Christians confess the Son of God; they confess everything that resembles the Father, and recognize in Him the sum and perfect revelation of God's divinity in his humanity and the plan for man that God has for every man. So, from the first Christmas, until today, nothing that is human can leave us indifferent. Because it is in the deep humanity of Jesus that we are  revealed the absolute divinity of Jesus himself.

We can try to avoid the meaning of Christmas with a thousand expressions and terms. In the name of ideological pluralism and respect for a thousand beliefs, we can try to avoid the meaning of Christmas or confuse it with another holiday, with other breaks during the year, but we cannot help but recognize that the proposal of Jesus of Nazareth’s life and work is still a call, an invitation for the construction of "a new heaven on a new earth," for the construction of a personal and social life according to another logic, another criteriology ... according to which we can love one another in absolute respect for the dignity and fundamental rights of every human being: with love and absolute respect for man and for all men.

Christmas is, then, a bimillennial memory of what happened in Bethlehem; it is a gift from God for the world in the child in the manger, but it is also and above all a proposal, an invitation, a call, a challenge, a task, a commitment.... MERRY CHRISTMAS!

Give Thanks...And Find Happiness

TO GIVE THANKS is an action that arises from our ability as humans to recognize the goodness and beauty in our lives, in our environments, in others, in all that is, all that we have, and all that happens.

Celebrations in which we give thanks have always been held in the most diverse communities, eras and cultures throughout the history of humanity. Here, in the United States of America, we have all grown up knowing and celebrating the historic feat in which, in the origins of this great Nation and specifically in the year 1623 in Plymouth (in the present-day state of Massachusetts) a meeting and a meal of thanksgiving took place for a good harvest. In the beginning, when the colony of Plymouth did not have enough food to feed half of its 102 settlers, natives of the Wampanoag tribe helped the pilgrims by giving them seeds and teaching them how to fish. The practice of carrying out a harvest festival did not become a regular tradition in New England until the late 1660s.

This Nation then has, in its historical foundations, a celebration of THANKSGIVING that has been commemorated from generation to generation and that has become the most important annual holiday for all American families.

It is a celebration, then, that commemorates the historical deeds that gave rise to the Nation we inhabit, in which we live, love, work, dream and hope. ... But it is, above all, a celebration - as its name indicates – in which we thank, give thanks, learn to give thanks, give thanks again. ...

Our current situation in society is defined and conditioned by a culture in which one must have money to be part of the world of the market, of the world of supply and demand, of materialism and consumerism; a world where you have what you buy, you have what you can have, what you deserve, what - through your labor and economic effort - you achieve and you get.

In this economistic vision of the human being and of society, we are losing the ability to perceive in daily human existence the gift of life; the value of what cannot be bought or sold is lost; the value of intangibles like love, family, encounters, solidarity, friendship, kindness, etc., is being replaced by the value of things and objects, by tangibles, by the material and immediate, by the ephemeral, by the disposable and temporary.

For this reason, THANKSGIVING DAY reminds us again of the importance of gratitude in the life of the human being, the urgency of being able to, again and every day, recognize the reasons we have to give thanks and be happy. Because the man who is able to give thanks is a happy man and he is happy when he is able to find and recognize in life the reasons to be grateful.

But THANKSGIVING DAY is not just a day for giving thanks. It must also be a day that pushes us to build reasons to continue to be grateful and to give thanks. It must be a national holiday in which we all commit ourselves to building a society in which we all have reasons to GIVE THANKS. In other words, it must be a day when there is not a single man or woman in the United States who does not find or does not have valid reasons to GIVE THANKS. And this is only possible if we all build better relationships, better family relationships, fairer economic relationships, more supportive political relationships, more humane cultural relationships, etc.

On this THANKSGIVING DAY 2018, I wish that all of us have reasons to be grateful and that, amongst us, we build a Nation in which during this holiday, this Nation’s principal event, all who live here can celebrate with genuine reasons, and in fair, just, and humane conditions for GIVING THANKS. Happy Thanksgiving!

The History of the Encuentro

Currents News 
Published on September 20, 2018 

Catholics from around the country are heading to Texas for the V Encuentro. Currents News anchor Liz Faublas talks with expert on the history of the Encuentro, Mario J. Paredes, who is also the founder of the board for Catholic Association of Latino Leaders. 

Health-care reform & the lost art of healing

In 1996, the renown Dr. Bernard Lown—emeritus professor of cardiology at Harvard and founder of the Lown Cardiovascular Group, among other distinctions—published “The Lost Art of Healing.” The book may be more than 20 years-old, but its message is as timely as ever, and arguably more urgent today then in 1996. The New York Times put the spotlight on Dr. Lown’s message when it recently ran an Op-Ed by an intern at Brigham and Women’s hospital in Boston who encountered the venerable physician when Dr. Lown was in that hospital being treated for pneumonia.

In “The Lost Art of Healing,” Dr. Lown charged that “doctors no longer minister to a distinctive person but concern themselves with fragmented, malfunctioning” parts of the body. The doctor-patient relationship, the author lamented then, and still laments today, has become impersonal, mechanical, remote and cold. In “The Lost Art of Healing” he called for the revival of the “3,000-year tradition, which bonded doctor and patient in a special affinity of trust.”

As resident physician Rich Joseph wrote in his column, Dr. Lown has called for “a return to the fundamentals of doctoring—listening to know the patient behind the symptoms; carefully touching the patient during the physical exam to communicate caring; using words that affirm the patient’s vitality; and attending to the stresses and situations of his life circumstances.” 

At 96, Dr. Lown made it clear that he was not pleased with the state of affairs he had warned about all those years ago, and which today he describes as the “industrialization of the medical profession.”

The Times piece is worth quoting at length because it so pointedly and accurately describes the state of contemporary health-care in the US, both in its for-profit and publicly-funded forms. The case is worse for the latter, with traditional Medicaid being particularly prone to impersonal medical care and an emphasis on transactional treatment in the form of tests and perfunctory office visits; a formula that is prone to waste and fraud, and that provides very little if any opportunity for the establishment of a bond between patient and doctor.

Enter the Delivery System Reform Incentive Payment (DSRIP) Program, a pioneering approach to Medicaid ushered in by the New York State Department of Health that has just begun the fourth year of its five-year mandate. Its goal: the reduction by 25 percent of avoidable hospital use at the end of five years, which would amount to a savings of more than $12B for New York State taxpayers. 

These are impressive facts and figures; important as they are for the bottom line, they are secondary. At the heart of DSRIP is superior, holistic care for Medicaid patients who are treated as human persons, not as cost centers or bundles of various medical ailments—care precisely of the kind Dr. Lown insists has gone missing.

SOMOS Community Care is one of 25 so-called Performing Provider Systems (PPS) in New York State, which are funded by DSRIP. To qualify for maximum funding, each PPS is held to strict deadlines, delivering certain levels of care and meeting crucial milestones all, ultimately, leading to those dramatic reductions in hospitalizations. DSRIP is driven by the Value-Based Payment (VBP) or Pay-for-Performance formula. That means that physicians and other providers are not paid according to tests administered or office visits logged, but based on the longer-term health outcomes of their patients. If their patients stay healthy, their doctors earn more. It’s that simple.

VBP, however, is a tool, not an end in itself. Value-based care means that doctors are rewarded, are recognized, for paying closer attention to their patients. Better care, to cite Dr. Lown once again, depends on the development of that “affinity of trust” between doctor and patient. Such an authentic bond requires that doctors make a genuine effort to get to know their patients, which takes time, energy and resources.

Providing truly superior care means that doctors and their staff must go the extra mile not only to comprehensively assess a patient’s physical, as well as mental health; it also means getting to know the patient’s family, the family’s living conditions, and to develop an awareness of the environmental and social factors that affect the home life—the so-called social determinants of health, which Dr. Lown succinctly describes as the “stresses and situations of [the patient’s] life circumstances.” Only in this labor-intensive, patient, persistent and demanding fashion can doctors once again become genuine healers, patients’ confidants, who are trusted and admired leaders of their communities. 

SOMOS Community Care is unique among the 25 PPSs in New York State in that it provides services to the poorest residents of New York City through a network of independent physicians. The other PPSs are hospital-based, mostly massive corporate systems, for which the genuinely and indispensable personal touch is much harder to achieve. SOMOS supports its physicians with a team of Community Health Workers, which train the staff of physician’s practices in digital record-keeping—freeing up the doctor to give his or her full attention to the patient—and which make home visits as needed, making sure medical appointments and regiments are kept, and giving the doctors vital feedback on patients’ home circumstances.

SOMOS, in sum, is making for the contemporary reiteration of the family doctor of old, making him or her again a familiar and relied upon neighborhood figure. In many cases, our doctors live and work in the same communities as their patients, often sharing their ethnic background. Cultural sensitivity and competence, in fact, are a hallmark of the DSRIP VBP formula.

It must be stressed that our more than 2,000 doctors, most of them members of Independent Practice Associations, have gone out on a limb in signing up with DSRIP. The old Medicaid formula stood for a predictable, reliable level of income. The Pay-for-Performance model, by contrast, means that doctors have to work harder, and provide superior health-care, in order to qualify for higher compensation. As independent small business people, our doctors are really taking a chance and deserve a great deal of credit for thus boldly embracing their professional calling in a way that is by no means risk-free.

Value-based care is the new wave of health-care reform; it will deliver superior care, thanks, in part, to a strong emphasis on preventive care. This, in turn, translates into reduced health-care costs by keeping people healthier and out of hospitals, etc. It would make a lot of sense for policy-makers to begin paying closer attention to value-based care—and to consider funding the efforts of Independent Practice Associations. This would enable the independent doctor as entrepreneur to succeed under the VBP regime by providing truly personalized health care, whose quality hinges on that “affinity of trust” between doctor and patient. This would be a much-needed complement to the massive funding of inevitably more impersonal hospital-based systems that currently dominate the publicly-funded health-care arena.

As for SOMOS, we are laying the groundwork for life beyond the DSRIP mandate, which concludes on March 31, 2020. SOMOS Community Care will continue operations as a for-profit entity. Experience to-date has given us confidence in the VBP formula and we are prepared to, literally and figuratively, bank our future on it!

Standing up for immigrants worldwide!

The phenomenon of human migration is among the most complex and massive global crises of our time; it is the greatest cause of human suffering and the tragedies humanity is experiencing in our day. 

It is a very complex phenomenon because it forces to the surface all the unresolved challenges faced by humanity in making this world more humane and just; it brings to the fore the urgency of creating genuine solidarity among all the countries and peoples worldwide. There is administrative and outright governmental corruption in various countries; social inequality; social injustice, plus a thousand forms of violence and death, epidemics, famine, intolerance, racism, and various other forms of discrimination, etc.

The number of people involved, the sheer size of the worldwide migration phenomenon, already transcends all borders, races, creeds, cultures, and ideologies. The migration and refugee crisis has become a part of daily life, creating the Dantesque dimensions of a living hell on earth. The crisis is subhuman and apocalyptic in the suffering it inflicts upon men, women, children, young people and the elderly, all of whom, for the greatest variety of reasons, were forced to leave their homelands to look for a better future abroad—to try to begin new lives in strange and foreign lands, many of which are nakedly hostile to the newcomers.

This phenomenon of mass migration affects all of us. All humanity is united in the good as well as implicated in the evil inherent in how the world responds to the crisis. Sadly, the search for and implementation of fundamental solutions to the crisis are postponed indefinitely: everyone, leaders and citizens alike, are wholly lethargic in their response to the worldwide tragedy—all of us simply prefer to avoid dealing with the problem.

Those who are the primary victims of this migration phenomenon are—for the most part—men and women on the fringes of society, suffering the shame of their position of being people who are unwanted. They are the products, the victims of what Pope Francis calls "the culture of discarding;” the throw-away culture; they are what he labeled "the disposable." They are men and women who have become impoverished because they are being denied all access to social services and social opportunities; they are simply "discarded" because they aren’t important players in the hyper-productive economic machinery that drives this globalized world.

The causes of this painful and massive migration phenomenon are many; they range from people’s desperate search for better economic conditions, to displacements under duress due to political or religious persecution, as well as other forms of violence which make remaining in their homeland impossible.

Examples of this phenomenon today are the huge masses of migrant and refugee populations that are making their way—often at the cost of risking their lives—from Africa to Europe; from Syria and Iraq to Europe, for example; and then there are people from around the entire world, including Latin America, trying to make it to the United States.

This complex, massive worldwide problem calls upon all of us to find solutions of equal magnitude and complexity: the crisis, first of all, calls for solutions in the countries of origin; and then for a strategic response to ameliorate the double suffering of those who have been uprooted from their countries of origin and then meet with hostility in new lands where they are decidedly unwelcome, even as they try to rebuild their broken lives. The countries that take in the greatest number of migrants must be able to call on the rest of the world for vital help in finding ways for the newcomers to integrate in their new homelands and build a new, dignified way of life. 

Until today, this phenomenon—which is so dramatic, so tragic, so visible, causing so much pain and bringing about so much social upheaval and individual suffering—this phenomenon which calls for such an urgent response, has been met with lack of action, with indifference, with governments badly failing to coherently and dynamically making a response to the crisis a priority.

The primary causes of the crisis are neglected or ignored: bureaucratic inefficiency and administrative corruption; social injustice; inequality in the distribution of resources, goods, services and social opportunities. What’s more, the very factors that force so many millions to emigrate also turn destination countries into hubs of misery, even as they continue to regularly attract thousands upon thousands from all corners of the earth, each and every day.

Neither the current politicians in each country of departure of these large migratory masses—who are, so often, victims of massive corruption—nor the governments of the country where the migrants seek to make their new home, nor the international agencies and entities charged with care of the most vulnerable—such as the European Union, the United Nations, the World Health Organization, the International Monetary Fund and the World Bank—are succeeding in resolving the current migration phenomenon through adequate humanitarian means. Instead, war-mongering and the show of military might are on display.

It is urgent, therefore, that we find ways to restore to all those affected their dignity as people—not with welfare programs, but through solutions that promote and sustain human development.

It is also urgent that faith-based institutions representing the gamut of creeds and religions contribute to comforting the suffering migrants; let their service and prophetic mission set the tone for secular governments. Religious leaders must fearlessly and consistently denounce all the aspects of the migration crisis that undermine human dignity, that impede the ability of all men, women and children affected by the crisis to lead dignified lives, as individuals and communities. Sad to say, the opposite is true today, with so many religious leaders having become co-conspirators of silence, demonstrating a glaring indifference to the migrants and refugees. 

We must create a world that serves as a great table of plenty at which all people have a seat, and where all are in solidarity, partaking in equal shares of the abundant life. This vital task should bring all of us together in unison and harmony. The failure to build a more humane global community, marked by solidarity, is a grave moral defeat, which should fill us with shame. So far, governments and civil society have done precious little—there is so much, so much more that we must do to bring comfort and healing to our migrant brothers and sisters from all around the world.

Easter: New and Abundant Life for All

DURING this time of year, the Catholic world prepares for the celebration of the most important holy day of the liturgical year: Easter—the Resurrection of Jesus Christ.

This essay will explore two aspects of this feast, two very important meanings that this holy day has for all of humanity, for the Christian world, and for our North American society.

First, the confession of faith in the Resurrection of Christ has a historical basis or reflection in the transformation of life experienced by the first Christians; these men and women recognized and proclaimed to each other and to non-Christians that they had become new men and women, with a transformed mentality. They were now able to understand the whole life project of Jesus of Nazareth; and now they could live out its principles and put them into practice, fueled by a new vision of God, of the world, and of the “other,” their neighbor.

Some of the disciples who had accompanied Jesus in his travels and ministry—his first witnesses, his intimates, but who clumsily did not understand him, and instead denied and abandoned him—now were sent into the world. Two thousand years ago they began their mission proclaiming that Christ was alive, that he lived in them because he had radically changed, renewed, and transformed their lives. Now they were living out, in its fullness, the commandment to love; they recognized that all men are brothers, children of the same Father in heaven—just as Jesus had taught and shown them.

How much we all need this each and every day: this personal renewal and this transformation in order to become better human beings, to transform ourselves—to move forward. This is precisely what the word Easter means in Hebrew: "to step," to step over and let go of resentments, fears, small and big hatreds, this focus on differences, intolerance, discrimination, quarrels, divisions, and all forms of violence and death. We all need to move forward toward new ways of understanding and living life--new, renewed and transformed ways of relating to each other. This makes coexistence possible, a coexistence that, even if it is not always fraternal, is at least humane and civilized!

For all of us, the first meaning of the Christian Easter is new life. And how much does this message of Easter not apply, with so much urgency and necessity, to our American society, in the here and now?

We are surrounded and distressed by a thousand forms of violence and death in our homes, our streets and our schools. We are overwhelmed by unemployment and dread of the future, fear of diseases and political uncertainty; then there is the use of drugs by so many people, especially the young, and the destruction addiction wreaks in so many families; plus, there is the loss or distortion of traditional values because of the primacy of having over being, the pursuit of pleasure and power at all costs—regardless of the means—as the ultimate goal of human existence, etc. 

This reality threatens to suffocate the potential of human life and harms and hardens the coexistence of all of us in contemporary society. The situation clamors—with great urgency—for a transformation, a change, a metanoia, a new life. It clamors for people whose lives are transformed as well as the reconstruction and renewal of institutions so that they become more just, more supportive, and more humane.

Second—and inseparable from the power of Easter to transform lives—the confession of the Resurrection of Jesus signifies a triumph of life over death, a step away from failure and toward victory. Thus, Easter also stands for an "abundance of life" as the ultimate destiny of human kind, of every man and woman who comes into the world.

Today’s many ills, as mentioned, that afflict and distress individuals and society at large, call us to a daily task; we have a calling to progress from the bad to the good, from the inhuman to the human and humane, from the mediocre to our best selves, from lies and errors to the truth and honesty, from the twisted and confused to a clear conscience. We can make such progress through our words and in our actions, building up—through that step forward, that transformation, that novelty in our lives—the room for abundant life.

Let us embrace abundant life, so that, in our nation, it can manifest itself in the realms of law and politics, in economics, and in the quality of inter-communal and interpersonal relations, in the world of art and sciences, in the exercise of our professions and in all our daily tasks, and so too in the world of entertainment, recreation and sports, in our religious practice, etc.

Our society—proud of and enriched by so many material achievements—is the stage for so many accomplishments and the reason for so much hope for so many who have come here or dream of doing so. Yet, at the same time, within and without or borders, there are so many who are suffering the pain of unfulfilled dreams, unfulfilled longings, and dashed hopes; the pain of a thousand injuries inflicted by unjust and inhuman ways of life. All of this demands from us that we embrace a new life—and invite others to do the same—to embrace Easter’s promise of an abundant life, the prosperous, full and happy life for which we all yearn.

Let it be Easter then every day. Let all our days witness our passage from the old to the new, and from scarcity, and petty and precarious ways of life, to a truly abundant life!

The brave new world of digital health care still needs doctor’s personal touch.

LAST MONTH two major publications devoted significant coverage to the growing, unstoppable trend toward telemedicine and other digital forms of measuring, recording and responding to individuals’ healthcare needs—all for the sake of convenience, accuracy and cost-cutting. The Economist (Feb. 3, 2018) headlined its news analysis with “Doctor You—a digital revolution in health care is coming—welcome it.” The Wall Street Journal (Feb. 25, 2018) published a lengthy feature on “What the Hospitals of the Future Look Like;” the subhead read: “The sprawling institutions we know are radically changing—becoming smaller, more digital, or disappearing completely. The result should be cheaper and better care.”

Optimism abounds. And, yes, there is plenty of reason for it. The Economist notes that the “fundamental problem with today’s system is that patients lack knowledge and control” regarding their medical condition and treatment options; “access to data can bestow both,” the article proclaims.

There has been a veritable explosion of wearable devices that measure blood pressure, for example; others can detect irregularities in heartbeat; other apps are in development that can—with the help of Artificial Intelligence—detect skin cancer and other potentially life-threatening conditions that, early on, do not manifest themselves in obvious, visible or dramatic ways. A digital early-warning system can prompt individuals to seek out medical care for preventive measures.

Care for the elderly is greatly improved by wearable devices that are capable, not only of measuring vital signs, but of detecting falls and sending warning signs to centralized monitoring stations. These, in turn, can dispatch emergency help or alert family members to take mom or dad to a doctor. In a similar fashion, patients of all ages, can have data pertaining to critical medical factors, such as diabetes, automatically sent to their doctors’ computers, prompting corrective instructions or, if needed, a visit to the doctor’s offices. Not surprisingly, Apple has announced plans to petition health-care organizations to allow iPhone users to download their medical records.

These innovations certainly give patients more autonomy in making medical decisions on their own behalf, while also serving as a safeguard to spot potential errors in medical records that could lead to inappropriate or unnecessary treatments. Overall, this digital revolution will save billions of dollars in unnecessary—or, no longer necessary—visits to doctor’s offices and the administration of medical tests.

As to hospitals, the Journal writes, these institutions, too, are developing monitoring systems that can sharply reduce the time patients spend in hospitals or emergency rooms by keeping a remote digital eye on the patients at home; again, the focus is on preventive care—catching conditions before they get out of hand. By some estimates, 30 percent of care traditionally provided in hospitals can be given at home.

More and more, somewhat parallel to the proliferation of no-appointment-necessary medical clinics, large hospital will make room for “microhospitals,” functioning as extended “intensive-care units, where you go for highly specialized, highly technical or serious critical care.” Patients with conditions that can safely be monitored remotely can recover at home. Doctors with various levels of specialization will operate “central hubs” to monitor both acute cases in microhospitals, regular ERs or less severe cases in patients’ homes.

Kenneth L. Davis, president and chief executive of Mount Sinai is quoted as saying: “We need a new model of care that focuses on wellness and prevention and keeps people out of hospitals.” Enormous savings and greater comfort for patients are in the offing.

As The Economist notes, “the benefits of new technologies”—such as wearable devices and downloadable personal health records—“often flow disproportionately to the rich. However, government and insurers have an incentive to provide the technology and self-care, at-home treatment options to poorer populations as well. Alphabet, the parent company of Google, has plans to wade through patient data in poorer parts of cities, where many residents are covered by Medicaid.

Hi-tech innovation at the service of the poor is also the hallmark of New York State’s revolutionary Delivery System Reform Incentive Payment (DSRIP) Program. DSRIP, a five-year program now its third year, provides superior medical care to Medicaid patients at greatly reduced savings ($12B-plus!) to the state’s taxpayers. DSRIP in on track to exceed its target of reducing unnecessary hospitalizations by 25 percent by spring 2020. The program is driven by the Value-Based Payment (VPB) or Pay-for-Performance model: doctors are being paid, not based on the number of hospital visits or tests, but on the longer-term health outcomes of their patients. (It’s promising in this regard that the government has created the Physician-Focused Payment Model Advisory Committee, with the potential of extending VBP models to Medicare.)

Electronic Health Records (EHRs) play a major role in DSRIP architecture; for the New York State Department of Health to track the health of populations, EHR data are integrated with Medicaid claims in order to paint the state of health of large communities. Just as is necessary in the commercial, privately-insured universe touted by The Economist and The Wall Street Journal, EHRs for each patient served under DSRIP must be painstakingly produced, maintained and constantly updated. This process ordinarily demands a great deal of time on the part of physicians, who are glued to their computer screens, rather than being focused on the patient before them.

In sum, the vital personal relationship between physician and patient, between doctor and the patient’s family, has little chance to be established. The personal touch, the human encounter that forms the foundation of an authentic patient-doctor relationship goes missing. That obviously is true for all forms of remote monitoring of patients’ health, no matter how accurate or efficient.

At SOMOS Community Care we have developed a solution; SOMOS is the only so-called Performing Provider System (PPS) mandated by DSRIP that consists of a network of independent physicians; the other 24 PPSs are hospital-based. To free our doctors from the demands of data entry and record keeping, we have dispatched teams of Community Health Workers (CHWs) to our practices, to record patient data themselves or train office staff to do so.

As a result, the doctor—often living and working in the very communities with whom he shares a cultural and ethnic background—is free to pay full attention to patients before him; what’s more the CHWs make home visits, as needed, ensuring that patients keep up with their medical regimen and keeping the doctor abreast of family and housing circumstances that may impact the health of patients and their families.

In this fashion, our doctors assume the role of the family doctors of old—leaders of the community in whom patients can put their trust, in whom they can confide, and by whom they are understood, by whom they are truly known. This new iteration of the family doctor takes full advantage of today’s digital revolution in health care, but without sacrificing what has always been essential for an individual’s overall well-being—quite literally, the personal, healing touch. Such cannot be transmitted in digital fashion, no matter how sophisticated the technology.

Five Years with Pope Francis

FOLLOWING the historic and surprising decision by Pope Benedict XVI to resign from the pontificate, first announced on Feb. 11, 2013, the conclave of cardinals elected a new Pontiff. A Jesuit and the former archbishop of Buenos Aires, Jorge Mario Bergoglio who chose the name Francis as a sign that his Petrine ministry would be a tribute to and would aim to fulfill the mission of the Poverello of Assisi: Saint Francis. 

March 13, 2018 will mark the fifth anniversary of the election of Pope Francis; he is the first Jesuit Pope, the first from the Americas, the first from the southern hemisphere, and the first from outside of Europe since the Syrian Gregory III, who reigned in the 8th century. 

Without a doubt, the first five years of this unique pontificate have seen the realization of the dream of St. John XXIII. St. John, when he so wisely and joyfully convened Vatican II on Jan. 25, 1959, had a vision and Pope Francis is making it a reality: his unique style of ministry has brought fresh air and renewal to the Church. As the Greek philosopher Protagoras said: "Man is the measure of all things." And the style that Francis has imprinted on his pontificate reflects the essence of his own humanity, his Christian, priestly and Jesuit life. This essence can be summarized in three words: nearness, humility and mercy. Better still, a single sentence captures the core of this papal reign: the pontificate of Francis has been a ministry of nearness, humility and compassion. 

This pontificate has been near to the realities that Francis himself calls peripheral realities, both geographically and human, pertaining to the whole of society as well as to the ecclesial community itself. These are peripheral realms where those most in need of the light of the Gospel and the compassionate and merciful love of God live and suffer; Pope Francis insists that the Church’s disciples of Christ are called to convey God’s love to those discriminated against in a thousand ways—because of their creed, race, origins, sexual identity; these are the poor among the poor, the marginalized, the rejected, the impoverished, migrants, the divorced, etc. 

It is this closeness to the realities of all men and women around the world from which Pope Francis crafts the catholicity or universality of the Church. It is a closeness that translates into dialogue and openness to all the realities of the individual and the realities of all people. 

This pontificate is humble, simple, transparent, open, frank, coherent—a friend to all. This is the personality of the man Jorge Mario Bergoglio, which is lived out and manifested in all the deeds and words of Pope Francis. They are many—his gestures; they are novel, austere, refreshing, disrupting, prophetic and full of the joyful and humble evangelical meaning that Francis has delivered throughout these five years in charge of Peter's barque.

These are gestures that—in coherent fashion—accompany all of Francis’ talks and homilies; there is the acknowledgement of himself as a sinner and his consistent acknowledgement of the sins of the Church; his constant petition for us to pray for him; the choice of his papal residence and the car in which he travels; there is his closeness to the sick and incarcerated, as shown in the washing of their feet on Holy Thursday; the choice of his vestments and ornaments; the manner of his presentation as the Bishop of Rome; his vindication as a man of the common people, etc. His is a humble closeness to all of humanity that is recognized by the entire world and paid tribute to by the hundreds of covers of the most important magazines around the world. 

This papacy is merciful: compassion and mercy most particularly characterize the revelation of the love of God for human beings shown by Jesus of Nazareth. If one thing characterizes the exercise of Peter's ministry by Pope Francis, it is his insistence on mercy in all his gestures and all his preaching. Mercy is so characteristic of the life and work of Francis that, to celebrate the 50th anniversary of the closing of Vatican II, he called on the whole Church on March 13, 2015 to celebrate an extraordinary Holy Year and Jubilee of Mercy. 

This distinct personality and nearness to the marginalized—this ministry that is both humble and compassionate—does not impede or diminish Pope Francis’ authority, wisdom, strength, determination and courage to push for (and face opposition to) the radical reforms that are urgently needed within the Vatican Curia and the Catholic Church at large. 

This spirit of humility and compassionate closeness to those most in need of God’s love is of course evident and manifest in all the writings of this pontificate, the hundreds of talks, letters, homilies, etc. Add to these his messages delivered during his pastoral travels and in his larger texts. Among these stand out: 

Encyclical Letters: 

• Laudato si (On Care for our Common Home)
• Lumen Fidei (on the Light of Faith) 

The Apostolic Exhortations: 

• Amoris Laetitia (on love in the family)
• Evangelii Gaudium (on the proclamation of the Gospel in today’s world). 

Nothing remains, but to: 

Celebrate and express our gratitude with enormous joy and Christian jubilation for the blessings given to the world and to the Church during these first five years of the pontificate of Francis. 

Ask that there be many more years to come, in which—as the head of the Church—Francis will accompany us with his humble and compassionate nearness. Respond to his constant request to pray for him, so that God may grant him wisdom, health and strength in his Petrine ministry. 

Follow him, listen to him and try to imitate him in pursuing the authentic Christian life. 

And for the good of the Church and the entire world: AD MULTOS ANNOS POPE FRANCIS! 

Pope Francis in Chile

Thirty years after the pastoral trip of St. Pope John Paul II to Chile, the current Pope Francis undertook his sixth visit to Latin America, this time visiting Chile and Peru (between January 15 and January 22) during different historical, social, and political circumstances, that are always changing, of course. On the last papal visit in 1987, for example, Chile was under the military and dictatorial regime of Pinochet. Today, Chile lives in a regime of democratic government.

Enlightening the minds and hearts of men and women of good will, Pope Francis, in his mission and style, confirms and encourages the faith of Catholics, and helps clarify - by the light of the Gospel of Jesus Christ - today's problems, of the men and the peoples he visits. He presented the Good News of Jesus with current themes, very near and very close to the feelings and the deepest, most intimate, and most current experiences and urgencies of the life of each audience.

With the emotion of a Catholic and with the pride of being Chilean, with the fresh joy of the encounter with Francis and with gratitude to God for the privilege of having been present in this Apostolic Journey as a special guest of the Chilean government, let me emphasize here, very briefly, the thoughts, the themes, the strong ideas, and the most important moments, of the speeches delivered by Pope Francis to the Chilean people, transcribing his very words to preserve them - just as they were delivered, without interpreting them or changing them, for our reflection and Christian life.

At the MEETING WITH THE AUTHORITIES, THE CIVIL SOCIETY AND THE DIPLOMATIC CORPS at the Palacio de la Moneda in Santiago de Chile on Tuesday, January 16, 2018, the Pope reminded all Chileans of the challenge that should enliven the days of this Nation in its present and near future: "a great and exciting challenge: to continue working to make this democracy, as your forebears dreamed, beyond its formal aspects, a true place of encounter for all. To make it a place where everyone, without exception, feels called to join in building a house, a family and a nation. A place, a house and a family called Chile: generous and welcoming, enamored of her history, committed to social harmony in the present, and looking forward with hope to the future. Here we do well to recall the words of Saint Alberto Hurtado: “A nation, more than its borders, more than its land, its mountain ranges, its seas, more than its language or its traditions, is a mission to be fulfilled.”  It is a future. And that future depends in large part on the ability of its people and leaders to listen.”’ And, added the Pope: to especially listen: 

•  “TO THE UNEMPLOYED, who cannot support the present, much less the future of their families;

•  TO THE NATIVE PEOPLES, often forgotten, whose rights and culture need to be protected lest that part of this nation’s identity and richness be lost;

•  TO THE MIGRANTS, who knock on the doors of this country in search of a better life, but also with the strength and the hope of helping to build a better future for all;

•  TO YOUNG PEOPLE, and their desire for greater opportunities, especially in education, so that they can take active part in building the Chile they dream of, while at the same time shielding them from the scourge of drugs that rob the best part of their lives;

• TO THE ELDERLY, with their much-needed wisdom and their particular needs. We cannot abandon them. 

• TO THE CHILDREN, who look out on the world with eyes full of amazement and innocence, and expect from us concrete answers for a dignified future.”

And, at this moment of his intervention, Pope Francis added a request for forgiveness that was very just, necessary, and anticipated by the Chilean people in this Apostolic Visit: "Here I feel bound to express my pain and shame, shame at the irreparable damage caused to children by some ministers of the Church. I am one with my brother bishops, for it is right to ask for forgiveness and make every effort to support the victims, even as we commit ourselves to ensuring that such things do not happen again.”

In the Homily of the Eucharistic Celebration FOR PEACE AND JUSTICE at O'Higgins Park in Santiago de Chile on Tuesday, January 16, 2018, he reminded us that "the Beatitudes are not the fruit of a hypercritical attitude or the “cheap words” of those who think they know it all yet are unwilling to commit themselves to anything or anyone, and thus end up preventing any chance of generating processes of change and reconstruction in our communities and in our lives. The Beatitudes are born of a merciful heart that never loses hope. A heart that experiences hope as “a new day, a casting out of inertia, a shaking off of weariness and negativity” (Pablo Neruda, El habitante y su esperanza, 5) and he added that "peacebuilding is a process that calls us together and stimulates our creativity in fostering relationships where we see our neighbor not as a stranger, unknown, but rather as a son and daughter of this land.”

During his brief visit to the Women’s Penitentiary of Santiago, the Holy Father reminded the inmates that " losing our freedom does not mean losing our dreams and hopes.... Losing our freedom is not the same thing as losing our dignity.... No one must be deprived of dignity." He also said that "public order must not be reduced to stronger security measures, but should be concerned primarily with preventive measures, such as work, education, and greater community involvement.”

On the same day, Tuesday, January 16, and at the MEETING WITH THE PRIESTS, CONSECRATED MEN AND WOMEN AND SEMINARIANS at Santigo Cathedral, he encouraged them to "renew our ‘yes’, but as a realistic ‘yes’, sustained by the gaze of Jesus.” He invited them to pray, saying “the Church that I love is the holy Church of each day.… Yours, mine, the holy Church of each day… Jesus Christ, the Gospel, the bread, the Eucharist, the humble Body of Christ of each day. With the faces of the poor, the faces of men and women who sing, who struggle, who suffer. The holy Church of each day.” And he ended his speech asking them: "What sort of Church is it that you love? Do you love this wounded Church that encounters life in the wounds of Jesus?”

At the MEETING and GREETING OF THE POPE WITH THE BISHOPS OF CHILE in the Santiago Cathedral Sacristy, he told them that "the lack of consciousness of belonging to God’s faithful people as servants, and not masters, can lead us to one of the temptations that is most damaging to the missionary outreach that we are called to promote: clericalism, which ends up as a caricature of the vocation we have received.”

On Wednesday, January 17, in the Homily of the Eucharistic Celebration FOR THE PROGRESS OF PEOPLES at Maquehue Airport in Temuco, the Pope addressed especially the members of the Mapuche people, as well as the other indigenous peoples who live in these Austral lands: the Rapanui (Easter Island), the Aymara, the Quechua and the Atacameños, and many others... and at this airport in Maquehue, in which serious human rights violations took place. The Pope called for our construction - as artisans - of unity and the recognition of (original) cultures without violence, saying that "the unity sought and offered by Jesus acknowledges what each people and each culture are called to contribute to this land of blessings” and that “you cannot assert yourself by destroying others, because this only leads to more violence and division. Violence begets violence, destruction increases fragmentation and separation. Violence eventually makes a most just cause into a lie.”

In the MEETING WITH THE YOUTH, in the National Shrine of Maipú, he exhorted them to be "the protagonists of change. To be protagonists. Our Lady of Mount Carmel accompanies [them] so that [they] can be protagonists for the Chile of which [their] hearts dream.” And, he reminded them that "maturing means growing and letting dreams grow and letting aspirations grow, not lowering your guard…” He also said: "How much the Church in Chile needs you to ‘shake the ground beneath our feet’ and help us draw closer to Jesus!  This is what we ask of you, that you shake the ground beneath our fixed feet, and help us to be closer to Jesus.”

In the VISIT TO THE PONTIFICAL CATHOLIC UNIVERSITY OF CHILE, the same Wednesday, January 17, he recalled the importance of the identity, of the existence and mission of the Catholic University for national coexistence and for the construction of community, telling them that the construction of coexistence “is not so much a question of content, but of teaching how to think and reason in an integrated way. What was traditionally called forma mentis.…The university, in this context, is challenged to generate within its own precincts new processes that can overcome every fragmentation of knowledge and stimulate a true universitas.” And, added the Pope, we must "seek out ever new spaces for dialogue rather than confrontation, spaces of encounter rather than division, paths of friendly disagreement that allow for respectful differences between persons joined in a sincere effort to advance as a community towards a renewed national coexistence.”

Finally, in the Homily of the Eucharist in honor of OUR LADY OF MOUNT CARMEL and in the PRAYER FOR CHILE as a Farewell, in the Lobito Campus of Iquique, on Thursday, January 18, the Holy Father encouraged us all to "like Mary at Cana… be attentive to all situations of injustice and to new forms of exploitation that risk making so many of our brothers and sisters miss the joy of the party. Let us be attentive to the lack of steady employment, which destroys lives and homes. Let us be attentive to those who profit from the irregular status of many migrants who don’t know the language or who don’t have their papers “in order”. Let us be attentive to the lack of shelter, land and employment experienced by so many families. And, like Mary, let us say: They have no wine, Lord.”

After this wealth of prophecy delivered by the Pontificate of Francis in Chilean lands, nothing remains but:  

• Regret, if the sensationalism and the media’s curiosity focused voraciously, rampantly, vulgarly and commercially on the subject of sexual scandals and on the person of a Chilean bishop accused of protecting a pedophile priest, a matter that the Pope himself denied and in which he came out in defense of the bishop and - as noted above – for which he asked for forgiveness. Sensationalism and curiousity that - in some moments and sectors, then, could overshadow and forget the wealth and importance of the visitor and his pastoral and evangelizing mission. 

• To hope, with the construction and the active and generous contribution of everyone, that the Gospel’s seed watered in our Chilean Homeland by Francis bears - in the near future of our beloved Nation - good and abundant fruits.